Surgical instrument



5, 1938- GREENWALD 2,137,121

I SURGICAL INSTRUMENT Filed April 18, 1936 v 2 Sheets$heet 1nnnnnnnunnrrarnn n I: 10 F I I if I .12 LJ 16 45 J ff- 5 3 1 m p za No15, 1938. N A D 2,137,121

SURGICAL INSTRUMENT Filed April 18, 1936 2 Sheets-Sheet 2 Patented Nov.15, 1938 PATENT OFFICE 2,137,121 SURGICAL INSTRUMENT Isidor Greenwald,Gary, Ind.; Fannie Greenwald, executrix of Isidor Greenwald, deceased,as-

Ind., a corporation of Indiana signorto I. Greenwald Company, Inc.,Gary,

Application April 18, 1936, Serial No. 75,211

Claims.

This invention relates to surgical instruments and has special referenceto that class of instruments "used for dilating certain organs of thebody, and which are known as dilators.

One important object of the invention is to provide a novel instrumentof this class by which, when in use, the wall of the organ in which thedilator is inserted may in large part be open to visual inspection, theinstrument thus constituting a combined dilator and speculum. A secondimportance object of the invention is to provide a novel instrument ofthis class which may be expanded to any desired size within the limitsof the particular size of instrument so that such instrument may meetthe individual case requirements.

A third important object of the invention is to provide a novel form ofdilator so constructed that, when inserted and expanded, substantiallyall of the inner surface of the organ will be exposed for treatment andthose parts not exposed may be afterwards exposed by collapsing theinstrument, rotating it slightly and again ex panding it.

A fourth important object of the invention is to provide a novel dilatorwhich may be primarily expanded at its outer end and then ex panded atits inner end.

A fifth important object of the invention is to I Figure 1 is a sideelevation of the invention in its completely collapsed condition.

Figure 2 is a section on the line 2-.|2 of Figure Figure 3 is alongitudinal section of the dilator showing the rear or outer endexpanded and illustrating the use of an implement for effecting rapidexpansion of said end.

Figure 4 is a similar view but showing the front or inner end expandedand disclosing the means used for this purpose.

Figure 5 is a rear end elevation of the-dilator in its collapsedcondition.

Figure 6 is a section on the line 6-6 of Figure Figure 7 is a face viewof a certain ring plate forming part of the device.

Figure 8 is an edge view of the plate shown in Figure 7.

Figure Q is a view similar to Figure 7, but showing a companion plate tothat shown in Figure 7.

Figure 10 is an edge view of the plate shown in Figure 9.

Figure 1-1' is a side elevation partly in section of a nonexpansibledilator suitable to form part of an equipment including the dilatorshown in Figures 1 to 10. V

Figure 12 is a section similar to Figure 2, but showing a'modified rodsection for the dilator of this invention. 7

Figure 13 is a side elevation of an expander rod for use with thisinvention, a head of small diameter being shown thereon in section.

Figure 14 isa detail view showing a modified form of ring plate adaptedto be used herein.

In the embodiment of the invention as here illustrated but one size ofthe dilator is shown, but it is to be understood that such dilators willpreferably be furnished in sets of various sizes in order that thesurgeon may have an appropriate size for any particular case which hemay be treating, it being obvious that certain organs of the human bodywill admit only dilators of small diameter, which would be insufficientfor use in other organs, since the smaller size would fail to expand theorgan sufficiently for treatment or inspection. However, it is to benoted that, except for variations in the sizes of the parts, theconstruction is alike for all sizes.

In the construction of this device, there is provided at the front end abullet shaped head l0 having its rear end transversely slotted as at H.

Pins 12 are provided and pivoted on these pins I are the forward ends oflinks 13 which may thus swing in planes radial to the axis of theinstrument. The rear ends of these links are forked and the forks arespanned by pivot pins 14. In these forks are fitted the reduced forwardends of expander rods l5 which are ribbed and bevelled as in Figure 2,so that, when collapsed, they form in substance a round rod. The form ofthese rods in cross section may be varied as shown at |5a in Figure 12,where the rods are, in such cross-section, substantially sectors of acircle. In any case the rear ends of these rods are reduced like thefront ends.

At the rear of. the device there is provided a against the rear face ofthis plate l6 there is fitted a somewhat similar ring plate I! which isprovided with stamped or pressed portions forming radial grooved ribs l8on the face of the plate l'l confronting the plate IS. The two platesare firmly but removably fixed together by notched studs l9 whichcooperate with the hole 9' and latch members Ida which are pivoted inany suitable fashion at 9. The two plates may, of course, be permanentlyfastened together by means of rivets or screws. For the sake ofsimplicity, the latch is not shown in Figs. and 6, but the plates areshown fastened together by rivets. When the two plates are thus fittedtogether the grooves and the confronting portions of the plate l6 formradial guides or bearings so that the two plates may, as a unit, bedescribed as a ring plate provided with radial tubular guides. V

In place of the two plate arrangement just described, a single plate Ila(Fig. 14) may be used having tubular guides l8a soldered or otherwiseconnected thereto or formed integrally therewith. Through these guidesextend operating screws 20 each having its inner end forked to embracethe reduced rear end of a rod l5 and the'operating screws 20 and rods l5are connected pivotally by pins 2|. On the screws 20 are fitted thumbnuts 22 which bear against the peripheries of the plates l6 and I! atthe outer ends of the guides. It will be observed that rotation of thenuts 22 adjusts the rear ends of the rods l5 with respect to thelongitudinal axis of the instrument. In use, the instrument will beurged to collapsed position by the pressure of the wall of the organwherein it is inserted but, by proper manipulation of the nuts 22 therear ends of the rods I5 may be spread to any desired extent within thescope of the particular size of the instrument.

Under certain conditions of use the rear end of the instrument may beexpanded primarily with little force and in order to effect such primaryexpansion expeditiously there is provided a conical expander 23 whichmay be pushed in between the screws 29 as shown in Figure 3, so that thenuts, which have been moved by this action out of engagement with theplates l6 and ll, may be readily and rapidly rotated to bring them againinto contact with the ring plates after which the expander 23 may beremoved and further dilation may be accomplished by rotating the nuts.

It will be seen from Figure 3 that the device is there shown as expandedat its outer or rear end only. In order to expand the forward ends ofthe rods l5, there is provided an expander rod 24, on the front end ofwhich is screwed an expander plug 25 while on the rear end of the rod 24is screwed a handle 26. This plug is inserted between the rear ends ofthe rods I5 and pushed forwardly to assume the positions shown in Figure4, thus expanding the forward end of the dilator. After this the rod 24is unscrewed from the plug 25 and withdrawn as indicated in dotted linesin Figure 4. The device will now be in position for treatment orinspection of the organ Wall. 'It will be seen that, with the deviceexpandcd as in Figure 4, the rods 15 are spaced to expose large areas ofthe organ wall between them and cover only narrow strips of the wall.After treatment or inspection of these exposed wall portions, the partscovered by the rods 15 may be exposed by collapsing the instrument androtating it about 45. To collapse the instruring plate It in the form ofa fiat annulus, and

ment the rod 24 is screwed in the plug 25, and the latter withdrawnafter which the nuts are unscrewed.

In Figure 12 is shown an instrument which may be used to effect apreliminary dilation, as in badly constricted cases, prior to theintroduction of the expansible dilator. This instrument consists of ahandle 21 screwed on a rod 28 having a rounded point 29, and it isintended to supply several diameters of these rods 28 for use with theone handle. Also, this or another suitable handle may be used with theexpander rod 24a and expander plug 25a of Figure 13 for the smallersizes of instruments.

There has thus been provided a simple and eificient device of the kinddescribed and for the purpose specified.

The entire instrument may be made of a suitable rustless alloy or ofsteel plated with a suitable metal.

It is obvious that changes may be made in the form and proportions ofthe instrument and its associated parts without departing from thespirit of the invention. It is not, therefore, desired to confine theinvention to exact forms here shown, but it is desired to include allforms which come within the scope of the appended claims.

What is claimed is:

1. A dilator including a head, dilator rods' linked tosaid head, a ringplate surrounding the rear ends of said rods, and means carried by thering-plate and engaging the rear ends of said rods, said means beingarranged to adjust the rods independently with respect to the center ofsaid ring plate.

2. A dilator having a head at its forward end, dilator rods having theirfront ends linked to said rods to swing in planes radial to the axis ofthe dilator, a ring plate surrounding said rods, members mounted on saidring plate for radial sliding movement thereon, and connected to saidrods, said members being adjustable relative to the center of saidplate.

3. A dilator having ahead at its forward end, dilator rods having theirforward ends linked to said head, means to adjust the rear ends of saidrods with respect to the axis of the dilator, and a dilator pluginsertable between the rear ends' of said rods and movable forwardly tothe front ends of said rods whereby to adjust said front ends relativeto said axis.

4. A dilator having a head at its forward end, dilator rods having theirfront ends linked to said head to swing in planes radial to the axis ofthe dilator, a ring plate surrounding said rods, sliding means mountedon said ring plate for radial sliding movement thereon, said slidingmeans being connected to said rods and capable of adjustment relative tothe center of said plate, and other means for adjusting the front endsof said rods relative to said axis.

5. A dilator having a head at its forward end,

dilator rods having their front ends linked to 6. A dilator having ahead at its forward end, 7

dilator rods having their forward ends linked to said head, means toadjust the rear ends of said rods with respect to the axis of thedilator, and a dilator plug insertable between the rear ends of saidrods and movable forwardly to the front ends of said rods whereby toadjust said front ends relative to said axis, and a manipulating roddetachably'connected to said plug.

'7. A dilator having a head at its forward end,

dilator rods having their front ends linked to said rods to swing inplanes radial to the axis of the dilator, a ring plate surrounding saidrods,

screws mounted on said ring plate for radial sliding movement thereon,said screws having their inner ends connected to said rods, nuts on saidscrews for adjusting the screws relative to the center of said plate, adilator plug insertable between the rear ends of said rods and movableforwardly to the front ends of said rods whereby to adjust said frontends relative to said axis, and a manipulating rod detachably connectedto said plug.

8. A dilator having a head at its forward end, dilator rods having theirfront ends linked to said head to swing in planes radial to the axis ofthe dilator, a ring plate surrounding the rear.

ends of said rods, said ring plate being provided with radial tubularguides, screws mounted in said guides to slide therein and having theirinner ends connected to the rear ends of said rods, and nuts on theouter ends of said screws and bearing against the outer ends of saidguides.

9. A dilator having a head at its forward end, dilator rods having theirfront ends linked to said head to swing in planes radial to the axis ofthe dilator, a ring plate surrounding the rear ends of said rods, saidring plate being provided with radial tubular guides, screws mounted insaid guides to slide therein and having their inner ends connected tothe rear ends of said rods, and nuts on the outer ends of said screwsand bearing against the outer ends of said guides, and other means foradjusting the front ends of said rods relative to said axis.

10. A dilator having a head at its forward end, dilator rods havingtheir front ends'linked to said said head to swing in planes radial tothe axis of the dilator, a ring plate surrounding the rear ends of saidrods, said ring plate being provided with radial tubular guides, screwsmounted in said guides to slide therein and having their inner endsconnected to the rear ends of said rods, nuts on the outer ends of saidscrews andbearing against the outerends of said guides, a dilator pluginsertable between the rear ends of said rods and movable forwardly tothe front ends of said rods whereby to adjust said front ends relativeto said axis.

11. A dilator having a head at its forward end, dilator rods havingtheir front ends linked to said head'to swing in planes radial to theaxis of the dilator, a ring plate surrounding the rear ends of saidrods, said ring plate being provided'with radial tubular guides, screwsmounted in said guides to slide therein and having their inner endsconnected to the rear ends of said rods, nuts on the outer ends of saidscrews and bearing against the outer ends of said guides, a dilator pluginsertable between the rear ends of said rods and movable forwardly tothe front ends of said rods whereby to adjust said front ends relativeto said axis, and a manipulating rod for moving said plug.

12. A dilator consisting of a head, a ring member spaced therefrom and aplurality of dilating members pivotally connected to said head at one oftheir ends and connected to said ring at the other ends for radialsliding movement with respectto said ring.

13. In a dilator consisting of a head, rods expansibly connected theretoat one of their ends, sliding members pivotally connected to the otherends of said rods, and a ring-like structure having formed thereonbearings for said sliding members.

14. Dilating means according to claim 13 in which the ring-likestructure consists of two ring-like plates, one of which has groovestherein cooperating with the other plate to form bearings for saidsliding members.

. 15. A dilator having a head at its forward end, rods linkedjto saidhead, means to adjust the rear ends of said rods with respect to theaxis of the dilator, and other means to adjust the front ends of saidrods with respect to said axis, said second mentioned means beingremovable. ISIDOR GREENWALD.

